scholarly journals Two Cases of Giant Melanocytoma (Hyperpigmented Magnocellular Nevus)

2020 ◽  
Vol 6 (5) ◽  
pp. 344-352
Author(s):  
David I.T. Sia ◽  
Jorge Agi ◽  
Parampal Grewal ◽  
Laurie Russell ◽  
Ezekiel Weis

Melanocytoma or hyperpigmented magnocellular nevus is a variant of melanocytic nevus that is most commonly seen in the optic nerve, but has also been reported to occur in the iris, ciliary body, choroid, sclera, and conjunctiva. We present two cases of giant uveal melanocytoma with histopathology. The first case occurred in a 10-year-old girl who presented with decreased vision in the right eye and a mushroom-shaped pigmented choroidal lesion measuring 15.5 mm in apical height. The lesion was abutting the lens but not causing a cataract. This was diagnosed as a choroidal melanocytoma on open scleral window biopsy. The second case was in a 68-year-old lady, referred for a left nasal pigmented choroidal lesion measuring 8 mm in apical height and having a mushroom configuration. The lesion grew to 8.6 mm in height and was complicated by a vitreous hemorrhage and rhegmatogenous retinal detachment and was treated with iodine-125 plaque brachytherapy. Subsequently, the treated eye became a painful phthisical eye and was enucleated. Histopathology confirmed melanocytoma with extrascleral extension but without malignant transformation. Features of melanocytoma and other very large cases reported in the literature are discussed.

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.


2007 ◽  
Vol 17 (4) ◽  
pp. 677-679 ◽  
Author(s):  
M.N. Demir ◽  
N. Ünlü ◽  
Z. Yalniz ◽  
M.A. Acar ◽  
F. Örnek

Purpose To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment. Methods An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye. Results He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained. Conclusions The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.


2015 ◽  
Vol 6 (3) ◽  
pp. 448-452 ◽  
Author(s):  
Dan-dan Zhou ◽  
Kai Niu ◽  
Cheng-wei Lu ◽  
Ji-long Hao ◽  
Bing-jie Zhang ◽  
...  

Purpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from homemade fireworks. Following initial assessment involving maxillofacial computed tomography (CT) and suturing at the Emergency Department, he was transferred to our department for further evaluation because of his poor sight 1 day later. On examination, a skin laceration beneath the right eyebrow was noted, but the superior orbit was not fully visible on the maxillofacial CT performed 1 day previously. Therefore, an orbital CT scan was carried out on the second day, which showed a hyperdense ring embedded in the superior border of the orbital wall; the ring was surgically removed. On postoperative day 7, a fundus examination revealed resolving vitreous hemorrhage, blunt traumatic retinal detachment, and a large retinal tear superior to the macula. The patient refused to take surgery for retinal detachment into consideration. Therefore, we opted for oral steroids and careful observation. Results: After 2 months' observation, the large retinal tear had healed and white fibrous scar tissue had developed, and the retinal detachment superior to the macula had reattached itself spontaneously. The patient's vision had further improved to 20/200. During 1 year of follow-up, he remained clinically stable. Conclusion: To avoid missing the diagnosis, a complete history of the mechanism of injury and accurate imaging still prove most useful. Complete removal of the foreign body by the emergency physician is necessary because of the ocular toxicity of an iron-containing foreign body. As evidenced by the current case, oral steroids and observation for a period of several months is a management of choice for traumatic retinal detachment and retinal tear superior to the macula associated with homemade fireworks in children.


2017 ◽  
Vol 70 (6) ◽  
pp. 32-36
Author(s):  
O. Zadorozhnyy ◽  
◽  
Alibet Yassine ◽  
A. Kryvoruchko ◽  
G. Levytska ◽  
...  

Photopsia, floaters, visual field defects, loss in visual acuity, periocular pain, and dyschromatopsia are symptoms of rhegmatogenous retinal detachment in which early signs are Weiss ring, pigmented cells in anterior vitreous (tobacco dust sign), a general decrease in intraocular pressure and retinal detachment in a convex configuration. On the other hand, the demarcation line, secondary retinal cysts, and proliferative vitreoretinopathy are some of the late findings of detachment. Imaging of the retina is crucial in rhegmatogenous retinal detachment. Fundus photography, wide-field imaging systems, optical coherence tomography, and fundus autofluorescence tomography are beneficial for documentation and monitoring progression. Ultrasound imaging, computerized tomography, and magnetic resonance imaging may be helpful when the retina cannot be visualized in cases like vitreous hemorrhage and dense cataract. Diagnosis can be made with indirect ophthalmoscopy with indentation, and ultrasound imaging in an opaque medium. Differential diagnosis of rhegmatogenous retinal detachment is exudative and tractional detachment, as well as lesions that can mimic retinal detachment such as retinoschisis, intraretinal macrocysts, choroidal detachment, vitreous opacities and white with or without pressure lesions.


2021 ◽  
Vol 14 (6) ◽  
pp. e241354
Author(s):  
Parrina Sehgal ◽  
Subina Narang ◽  
Deepak Chandra

A 7-year-old boy with Marfanoid habitus presented with sudden and painless decrease in the vision of the right eye. Ocular examination revealed rhegmatogenous retinal detachment with 360° giant retinal tear in the right eye and small peripheral retinal breaks with lattice degeneration in the left eye. The patient underwent a 23-gauge pars plana vitrectomy with scleral buckling in the right eye and laser around the breaks in the left eye. At 1-week follow-up visit, the child presented with similar complaints in the left eye as were seen in the right eye. This was later managed effectively with 23-gauge pars plana vitrectomy only. So, with our case report, we would like to highlight the need for aggressive screening in children who are diagnosed with Marfan’s syndrome and the need for prophylactic treatment in the unaffected eye.


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